PREVALENCE OF NASAL CARRIAGE OF METHICILIN RESISTANT STAPHYLOCOCCUS AUREUS AMONG PUPILS

ABSTRACT

The prevalence of Methicillin Resistant Staphylococcus aureus(MRSA) was assessed among pupils of Compassion Home Nursery/Primary School AhiaekeNdume, Umuahia. Nasal swabs were collected from 35 males and 15 females. The swabs were cultured on Manitol Salt Agar (MSA). After isolation, 45 samples yielded bacteria growth and 39 of the isolates were identified as Staphylococcus aureus. The antibiotic sensitivity of the isolate was done using Kirby bauer disc of diffusion with Abek multi disc antibiotic susceptibility containing 8 antibiotic disc. 32 (82.06%) of the isolates were resistant to Cloxacillin which is a methicillin antibiotics. The isolates were mostly sensitive to Gentamycin and Streptomycin with 35 (87.74%) and 39 (94.87%) sensitive to Gentamycin and Streptomycin respectively. The prevalence of Methicillin resistance among the isolates was 32 (82.06%) this is very high level of Methicillin resistance to Staphylococcus aureusin the environment and suggests the need for constant monitoring to avoid possible future epidemic of MRSA.

TABLE OF CONTENTS

Title page                                                                                                                                                                                                                          i

Certification                                                                                                                                                                                                                       ii

Dedication                                                                                                                                                                                                                       iii

Acknowledgement                                                                                                                                                                                                                    iv

Table of contents                                                                                        v

List of tables                                                                                            vi

Abstract                                                                                        vii

CHAPTER ONE

1.1 INTRODUCTION                                                                  1

1.2 Aim of study                                     3

1.3 Objectives of study                                                     3

CHAPTER TWO

2.0 LITERATURE REVIEW                                              4

2.1 General concept                                                                             4

2.2 Methicilin resistant Staphylococcus aureus   5

2.3 Antimicrobial chemotherapy                                                                  6

2.3.1 Antibiotic resistance and sensitivity             8

2.4 Causes of antimicrobial resistance                                     9

2.4.1 Treatment                                                                                                                             11

2.4.2Mechanism of action of methicillin                                                                                      11

CHAPTER THREE

3.0 Materials and methods                                                                                                             12

3.1 Ethical consideration                                                          12

3.2 Sample collection                                                                            12

3.3 Media preparation                                                                                   12

3.4Isolation of Staphylococcus aureus                                                                                          12

3.5Confirmation test for Staphlococcusaureus   13

3.6 Standardization of test isolates                                                                  14

3.7 Antimicrobial susceptibility test                                                           14

3.7.1 Examination and measurement of zone of inhibition                           14

CHAPTER FOUR

4.0 RESULT                                                                                                                           15

CHAPTER FIVE

5.1 DISCUSSION                                                                                                                   19

5.2 Conclusion                                                                                         19

5.3 Recommendation                                                                                                                                                                                                                          20

References                                                                                                    21

LIST OF TABLES

Table           Title                                                        page

1              Occurance of Staphylococcus aureus in nasal carriage                             16

2Antimicrobial susceptibility profile of is olatedStaphylococcus aureus                                                                                                                                   17

3Percentage of isolates resistant to Methicillin (Cloxacillin).                                    18

CHAPTER ONE

1.1    INTRODUCTION

Staphylococcus aureus is one of the most successful adaptable pathogen. It is also common colonizer of the skin and nose carried by 10% - 30% of the total population of the bacterium can be carried asymptomatically for weeks or months on mucus membrane but only transiently on tact skin (Archer 1998; Rosina and Estipanos 2007).

Staphylococcus aureusis the most common bacteria cause for adverse range of infections including sepsis, pneumonia etc. (Lowy, 1998) it colonizes the skin and mucosa of human being and several animals’ species (Sapna, 2000). Although multiple body sites can colonizes in human being, the anterior names of the nose is most frequent carriage site for Staphylococcus aureusYare strongly correlated (Sheretz and Bassetti, 2001). Suggesting that contaminated hand most commonly cause the colonization of nasal nares. Nasal carriers can act as “cloud” individual during rhinitis dispersing Staphylococcus aureus in to the environment. Also causal association between Staphylococcus aureus nasal carriage and Staphylococcus aureus disease has been confirmed by many studies (Sapna, 2000). Therefore, it is important to study the prevalence of nasal carriage to prevent the spread of Staphylococcus is a gram positive, catalase positive, coagulase positive cocci bacterium that occurs in grape like clusters when viewed under the microscope. The bacteria are found to colonize the armpit,throat,nose(most frequently)and skin causing no harm unless it gets the bacteria into the body through damaged skin or injury this allows the bacteria to overcome the natural protective mechanism of the body leading to infection (Barnett, 1998)

Staphylococcus aureus reproduce asexually. The reproduction process starts by the organism reproducing its DNA. The membrane stretches out andseparates the DNA molecules the cells forms a hallow spaces that eventually divides into new cells wall does not fully separates from existing cell wall, which is why the cell are observed in clusters. This cell wall eventually reproduce and cell wall attach to it (Mansuri and khaleghi, 1997).

Staphylococcus aureus are responsible for food poisoning through the production of enterotoxin and pathogenecity.it is also associated with coagulase positive.it may also occur as a commensal on skin,nose(most frequently)and less frequent in throat,the occurrence of Staphylococcus aureusdoes not always indicate infection and therefore does not require treatment always .it can host phages. Staphylococcus aureus is extremely prevalent in atopic dermatitis patient who are less resistant to it than other people, it often causes complication and this disease is mostly found in fertile, active places including armpit,hair and scalp. The large pimple that appears in these areas may cause worse infection if popped. This can lead to staphylococcus scalded syndrome(sss), (Curran and Al-salhi, 2002).

Methicillin resistance Staphylococcus aureus(MRSA) is any strain of Staphylococcus aureus that has developed through horizontal  gene  transfer  and natural  selection  multi resistance  to beta lactam antibiotic  which include., penicillin, methicillin, nafcillin, oxacillin, ampicillin, and cephalosporine such as CAZ – ceftazidime, CTR – ceftriaxone  and  CEF – cefhalexin. Strains unable to resist these antibiotics are classified as methicillin susceptible. Staphylococcus aureus or MRSA. The evolution of such resistance doesnot cause the organism to be  more intrinsically virulent than strain of Staphylococcus aurous that have no antibiotic  resistance but resistance does not make MRSA  infection more difficult to treat with standard types of antibiotic and thus more dangerous.

MRSA is transmitted primarily by direct person to person contact(ie from one hand of an individual to another susceptible individual), also skin to surface contact. It is possible for a colonized person to pass the bacteria to others through casual contact.MRSA can also be spread by contact with the following surfaces e.g. bar-soap, door knobs, handset (Fogg,2002).

1.2 Aim of Study

This work is aimed as ascertaining the prevalence of nasal carriage of Staphylococcus aureus among primary school pupils and their susceptibility pattern to methicillin group of antibiotics.

1.3 Objective of Study

To determine thenasal carriage of Staphylococcus aureus amongst pupils.

To isolate the methicillin resistant strain of Staphylococcus aureus amongst the isolates.

To determine the susceptibility pattern of the methicillin resistant Staphylococcus aureus isolated.

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